Comparison 1. Mycophenolate mofetil versus azathioprine.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death: all cause	16		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
1.1 Follow‐up ≤ 1 year	16	2987	Risk Ratio (M‐H, Random, 95% CI)	1.13 [0.76, 1.68]
1.2 Follow‐up 1 to 4 years	7	1595	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.59, 1.20]
1.3 Follow‐up > 4 years	3	457	Risk Ratio (M‐H, Random, 95% CI)	0.80 [0.59, 1.07]
1.4 Longest duration of follow‐up	16	2987	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.70, 1.29]
2 Graft loss: including death	15		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
2.1 Follow‐up ≤ 1 year	15	2653	Risk Ratio (M‐H, Random, 95% CI)	0.80 [0.62, 1.02]
2.2 Follow‐up 1 to 4 years	6	1347	Risk Ratio (M‐H, Random, 95% CI)	0.83 [0.66, 1.04]
2.3 Follow‐up > 4 years	2	209	Risk Ratio (M‐H, Random, 95% CI)	0.70 [0.29, 1.66]
2.4 Longest duration of follow‐up	15	2653	Risk Ratio (M‐H, Random, 95% CI)	0.82 [0.67, 1.00]
3 Graft loss: censored for death	17		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
3.1 Follow‐up ≤ 1 year	15	2384	Risk Ratio (M‐H, Random, 95% CI)	0.68 [0.49, 0.94]
3.2 Follow‐up 1 to 4 years	6	1512	Risk Ratio (M‐H, Random, 95% CI)	0.85 [0.64, 1.13]
3.3 Follow‐up > 4 years	4	525	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.60, 1.25]
3.4 Longest duration of follow‐up	17	2540	Risk Ratio (M‐H, Random, 95% CI)	0.78 [0.62, 0.99]
4 Primary non‐function	11	1864	Risk Ratio (M‐H, Random, 95% CI)	0.47 [0.19, 1.18]
5 Malignancy: longest duration of follow‐up	6		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
5.1 Any malignancy	5	1735	Risk Ratio (M‐H, Random, 95% CI)	0.81 [0.60, 1.09]
5.2 Lymphoma/PTLD	5	1564	Risk Ratio (M‐H, Random, 95% CI)	1.26 [0.43, 3.66]
5.3 Non‐melanoma skin cancer	4	1416	Risk Ratio (M‐H, Random, 95% CI)	0.78 [0.46, 1.34]
6 Acute rejection: total	22		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
6.1 Follow‐up ≤ 6 months	19	3128	Risk Ratio (M‐H, Random, 95% CI)	0.65 [0.55, 0.75]
6.2 Follow‐up 6 to 12 months	10	2086	Risk Ratio (M‐H, Random, 95% CI)	0.65 [0.58, 0.74]
6.3 Follow‐up > 12 months	5	603	Risk Ratio (M‐H, Random, 95% CI)	0.78 [0.61, 0.99]
6.4 Longest duration of follow‐up	22	3301	Risk Ratio (M‐H, Random, 95% CI)	0.65 [0.57, 0.73]
7 Acute rejection: confirmed by biopsy	12		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
7.1 Follow‐up ≤ 6 months	10	2306	Risk Ratio (M‐H, Random, 95% CI)	0.59 [0.50, 0.69]
7.2 Follow‐up 6 to 12 months	4	714	Risk Ratio (M‐H, Random, 95% CI)	0.66 [0.49, 0.88]
7.3 Follow‐up > 12 months	1	148	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.40, 1.56]
7.4 Longest duration of follow‐up	12	2696	Risk Ratio (M‐H, Random, 95% CI)	0.59 [0.52, 0.68]
8 Acute rejection: steroid resistant/antibody treated	15		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
8.1 Follow‐up ≤ 6 months	11	2350	Risk Ratio (M‐H, Random, 95% CI)	0.53 [0.35, 0.80]
8.2 Follow‐up 6 to 12 months	5	740	Risk Ratio (M‐H, Random, 95% CI)	0.49 [0.29, 0.81]
8.3 Follow‐up > 12 months	2	223	Risk Ratio (M‐H, Random, 95% CI)	0.52 [0.11, 2.44]
8.4 Longest duration of follow‐up	15	2914	Risk Ratio (M‐H, Random, 95% CI)	0.48 [0.36, 0.65]
9 Chronic allograft nephropathy	3		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
9.1 Follow‐up ≤ 1 year	1	71	Risk Ratio (M‐H, Random, 95% CI)	0.65 [0.43, 0.98]
9.2 Follow‐up > 1 year	2	132	Risk Ratio (M‐H, Random, 95% CI)	0.86 [0.39, 1.87]
9.3 Longest duration of follow‐up	3	203	Risk Ratio (M‐H, Random, 95% CI)	0.69 [0.48, 0.99]
10 Infection: other (longest duration of follow‐up)	10		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
10.1 Aspergillus	4	1316	Risk Ratio (M‐H, Random, 95% CI)	2.61 [0.65, 10.58]
10.2 BK‐virus	1	56	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.3 Candida	4	1316	Risk Ratio (M‐H, Random, 95% CI)	1.00 [0.77, 1.31]
10.4 Candida tissue invasive	4	1502	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.34, 2.31]
10.5 Herpes zoster	4	1629	Risk Ratio (M‐H, Random, 95% CI)	1.28 [0.80, 2.04]
10.6 Pneumocystis carinii/jiroveci	5	1650	Risk Ratio (M‐H, Random, 95% CI)	0.19 [0.05, 0.69]
10.7 Urinary tract/cystitis	6	1553	Risk Ratio (M‐H, Random, 95% CI)	1.15 [0.93, 1.42]
11 Infection: CMV viraemia/syndrome	13		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
11.1 Follow‐up ≤ 1 year	13	2880	Risk Ratio (M‐H, Random, 95% CI)	0.98 [0.81, 1.20]
11.2 Follow‐up > 1 year	3	1240	Risk Ratio (M‐H, Random, 95% CI)	1.08 [0.77, 1.50]
11.3 Longest duration of follow‐up	13	2880	Risk Ratio (M‐H, Random, 95% CI)	1.06 [0.85, 1.32]
12 Infection: CMV tissue invasive	7		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
12.1 Follow‐up ≤ 1 year	7	1510	Risk Ratio (M‐H, Random, 95% CI)	1.73 [1.12, 2.69]
12.2 Follow‐up > 1 year	2	992	Risk Ratio (M‐H, Random, 95% CI)	1.51 [0.95, 2.40]
12.3 Longest duration of follow‐up	7	1510	Risk Ratio (M‐H, Random, 95% CI)	1.70 [1.10, 2.61]
13 Graft function: serum creatinine	15		Mean Difference (IV, Random, 95% CI)	Subtotals only
13.1 Follow‐up ≤ 1 year	15	2457	Mean Difference (IV, Random, 95% CI)	0.03 [‐0.07, 0.14]
13.2 Follow‐up 1 to 4 years	4	712	Mean Difference (IV, Random, 95% CI)	‐0.05 [‐0.14, 0.03]
13.3 Longest duration of follow‐up	15	2233	Mean Difference (IV, Random, 95% CI)	0.05 [‐0.05, 0.15]
14 Graft function: CrCl/GFR	6		Mean Difference (IV, Random, 95% CI)	Subtotals only
14.1 Follow‐up ≤ 1 year	5	970	Mean Difference (IV, Random, 95% CI)	1.74 [‐1.77, 5.25]
14.2 Follow‐up 1 to 4 years	3	376	Mean Difference (IV, Random, 95% CI)	1.44 [‐3.05, 5.94]
14.3 Follow‐up > 4 years	2	120	Mean Difference (IV, Random, 95% CI)	0.56 [‐3.48, 4.60]
14.4 Longest duration of follow‐up	6	976	Mean Difference (IV, Random, 95% CI)	1.56 [‐1.15, 4.27]
15 Graft function: proteinuria	2		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
15.1 Follow‐up 2 to 5 years	2	745	Risk Ratio (M‐H, Random, 95% CI)	1.00 [0.70, 1.43]
16 Graft function: proteinuria	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
16.1 Follow‐up ≤ 1 year	1		Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
17 Adverse events: gastrointestinal (longest duration of follow‐up)	11		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
17.1 Diarrhoea	11	2638	Risk Ratio (M‐H, Random, 95% CI)	1.55 [1.32, 1.83]
17.2 Abdominal pain	3	1311	Risk Ratio (M‐H, Random, 95% CI)	1.18 [0.97, 1.44]
17.3 Vomiting	4	1487	Risk Ratio (M‐H, Random, 95% CI)	1.27 [0.83, 1.94]
17.4 Gastrointestinal bleeding	2	575	Risk Ratio (M‐H, Random, 95% CI)	3.99 [1.07, 14.86]
17.5 Nausea	5	1573	Risk Ratio (M‐H, Random, 95% CI)	1.01 [0.85, 1.20]
18 Adverse events: other (longest duration of follow‐up)	8		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
18.1 New onset diabetes in patients without diabetes at baseline, insulin‐treated	4	445	Risk Ratio (M‐H, Random, 95% CI)	0.57 [0.34, 0.95]
18.2 Hypertension	1	319	Risk Ratio (M‐H, Random, 95% CI)	0.97 [0.64, 1.47]
18.3 Hyperlipidaemia	3	813	Risk Ratio (M‐H, Random, 95% CI)	1.41 [0.59, 3.39]
18.4 Elevated liver enzymes	3	272	Risk Ratio (M‐H, Random, 95% CI)	0.50 [0.21, 1.23]
19 Adverse events: haematological (longest duration of follow‐up)	12		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
19.1 Anaemia	5	1821	Risk Ratio (M‐H, Random, 95% CI)	1.07 [0.87, 1.31]
19.2 Severe anaemia	2	528	Risk Ratio (M‐H, Random, 95% CI)	1.42 [0.61, 3.28]
19.3 Leucopenia	12	2671	Risk Ratio (M‐H, Random, 95% CI)	1.04 [0.78, 1.39]
19.4 Severe leucopenia	3	1025	Risk Ratio (M‐H, Random, 95% CI)	1.44 [0.33, 6.19]
19.5 Thrombocytopenia	5	1492	Risk Ratio (M‐H, Random, 95% CI)	0.73 [0.52, 1.03]
19.6 Severe thrombocytopenia	2	992	Risk Ratio (M‐H, Random, 95% CI)	0.60 [0.11, 3.21]
20 Total cholesterol	2		Mean Difference (IV, Random, 95% CI)	Subtotals only
20.1 Follow‐up ≤ 1 year	2	219	Mean Difference (IV, Random, 95% CI)	‐2.57 [‐15.65, 10.51]